Ghosh AN, Walsh CJ, Maiden MJ, Stinear TP, Deane AM. Effect of dietary fibre on the gastrointestinal microbiota during critical illness: A scoping review. World J Crit Care Med 2025; 14(1): 98241 [DOI: 10.5492/wjccm.v14.i1.98241]
Corresponding Author of This Article
Angajendra N Ghosh, MBBS, Doctor, Researcher, Senior Lecturer, Department of Intensive Care, The Northern Hospital, 185 Cooper Street, Epping 3076, Victoria, Australia. angaj.ghosh@nh.org.au
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Mar 9, 2025; 14(1): 98241 Published online Mar 9, 2025. doi: 10.5492/wjccm.v14.i1.98241
Effect of dietary fibre on the gastrointestinal microbiota during critical illness: A scoping review
Angajendra N Ghosh, Calum J Walsh, Matthew J Maiden, Tim P Stinear, Adam M Deane
Angajendra N Ghosh, Department of Intensive Care, The Northern Hospital, Epping 3076, Victoria, Australia
Calum J Walsh, Tim P Stinear, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, Melbourne 3052, Victoria, Australia
Matthew J Maiden, Department of Intensive Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville 3050, Victoria, Australia
Adam M Deane, Department of Intensive Care Medicine, The Royal Melbourne Hospital, Parkville 3050, Victoria, Australia
Author contributions: Ghosh AN, Deane AM designed the review; Ghosh AN was the primary author; Maiden MJ, Walsh CJ, Stiner TP and Deane AM revised the manuscript and provided editorial comments.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Angajendra N Ghosh, MBBS, Doctor, Researcher, Senior Lecturer, Department of Intensive Care, The Northern Hospital, 185 Cooper Street, Epping 3076, Victoria, Australia. angaj.ghosh@nh.org.au
Received: June 21, 2024 Revised: September 27, 2024 Accepted: October 28, 2024 Published online: March 9, 2025 Processing time: 173 Days and 5.3 Hours
Abstract
The systemic effects of gastrointestinal (GI) microbiota in health and during chronic diseases is increasingly recognised. Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise. While changes in dietary intake can rapidly change the GI microbiota, the impact of dietary changes during acute critical illness on the microbiota remain uncertain. Dietary fibre is metabolised by carbohydrate-active enzymes and, in health, can alter GI microbiota. The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states, specifically during critical illness. Randomised controlled trials and prospective cohort studies that include adults (> 18 years age) and reported changes to GI microbiota as one of the study outcomes using non-culture methods, were identified. Studies show dietary fibres have an impact on faecal microbiota in health and disease. The fibre, inulin, has a marked and specific effect on increasing the abundance of faecal Bifidobacteria. Short chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient populations. Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness. More research is necessary to establish optimal fibre type, doses, duration of intervention in critical illness.
Core Tip: This review explores the influence of dietary fibre on the gastrointestinal microbiota, emphasizing its role in both health and critical illness. Dietary fibres promote the production of beneficial short-chain fatty acids that enhance health through multiple immunological and anti-inflammatory effects. While fibres like inulin and arabinoxylan oligosaccharides positively affect the microbiota in healthy individuals, their impact on critically ill patients remains uncertain. Limited studies suggest potential benefits but highlight the need for further research in critically ill populations.
